Incarceration is a key driver of racial disparities in community-associated methicillin-resistant Staphylococcus aureus infections in Cook County, IL

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-07-25 DOI:10.1016/j.annepidem.2025.07.027

Hannah Steinberg MPH , William Trick MD , Chad Zawitz MD , Robert A. Weinstein MD , Paul Won , Alla Aroutcheva MD PhD , Evan Snitkin PhD , Kyle J. Popovich MD MS , Jon Zelner PhD

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引用次数: 0

Abstract

Purpose

Describe inequities in community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) infections and identify social factors contributing to these disparities.

Methods

We characterized census tract-level risk factors for CA-MRSA infections in the Cook County Health (CCH) catchment population in Cook County, IL from 2009 to 2022 using hierarchical Poisson regression models. We conducted mediation analyses to estimate a) the total risk attributable to and b) proportion of between-tract disparities in CA-MRSA accounted for by census tract-level inequities in risk factors.

Results

CCH patients living in majority Black census tracts in Cook County had double the rate of CA-MRSA infections as compared to CCH patients living in majority white census tracts. Socio-economic indicators such as public transportation use and the presence of homeless shelters in a census tract were associated with CA-MRSA rates in multivariate analyses. However, jail admission rates explained the largest proportion of CA-MRSA burden (30 %) and racial inequities in CA-MRSA incidence (69 %).

Discussion

High risks of MRSA infection and colonization have consistently been documented among incarcerated and recently incarcerated individuals. Our results suggest that incarceration may also drive infections among non-incarcerated individuals living in communities with high levels of indirect exposure to jails, especially in majority Black census tracts.

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监禁是伊利诺斯州库克县社区相关耐甲氧西林金黄色葡萄球菌感染种族差异的关键驱动因素。

目的：描述社区相关耐甲氧西林金黄色葡萄球菌（CA-MRSA）感染的不公平现象，并确定导致这些差异的社会因素。方法：采用分层泊松回归模型，对2009-2022年伊利诺伊州库克县库克县卫生（CCH）集水区人口中CA-MRSA感染的普查通道水平危险因素进行了特征分析。我们进行了中介分析，以估计a)可归因于CA-MRSA的总风险和b)由人口普查通道水平的风险因素不平等所占的CA-MRSA通道间差异的比例。结果：生活在库克县黑人人口普查区的CCH患者的CA-MRSA感染率是生活在白人人口普查区的CCH患者的两倍。在多变量分析中，社会经济指标如人口普查区的公共交通使用和无家可归者收容所的存在与CA-MRSA发病率相关。然而，入狱率解释了CA-MRSA负担的最大比例（30%）和CA-MRSA发病率的种族不平等（69%）。讨论：MRSA感染和定植的高风险一直记录在被监禁和最近被监禁的个体中。我们的研究结果表明，监禁也可能导致居住在间接接触监狱的社区的非监禁个人感染，特别是在黑人人口普查区。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.